Speaker 1: 0:06

Welcome to the Uncomplicated Perimenopause Podcast. I'm Kate Grosvenor, your friendly perimenopause expert and life coach.

Speaker 2: 0:15

And I'm Gabriella Kate's daughter, representing all the women who are nowhere near perimenopause but want to understand it better.

Speaker 1: 0:23

Whether you're just starting your perimenopause journey deep into it, whether you're just starting your perimenopause journey deep into it or you're a loved one trying to support someone who is we've got you covered.

Speaker 2: 0:32

We'll be answering all of your burning questions, exploring the ups and downs, and sharing expert advice and personal insights.

Speaker 1: 0:39

So grab a cup of tea, get comfy and let's dive into the wonderful. Get comfy and let's dive into the wonderful, sometimes wild, world of perimenopause together.

Speaker 2: 0:47

And remember, no matter where you are on your journey, you are not alone.

Speaker 1: 0:55

Welcome to the Uncomplicated Perimenopause.

Speaker 3: 0:59

Hello, my darlings, we're back. We are back. We are back, huzzah, and this is Season 3, episode 1 of the uncomplicated perimenopause podcast. I'm kate grover, a perimenopause expert and life coach.

Speaker 2: 1:12

I can't remember what I used to say so I'm gabriella, kate's daughter. Yeah here to learn with you guys, or something?

Speaker 3: 1:18

yeah, you're just here, I'm stuck. Yeah, whatever, I'm here for the vibes. So we had a bit of a break, because you got poorly, then I got poorly, then Scott got poorly, and then it just went. Ooh yeah.

Speaker 1: 1:30

When was the last time? December?

Speaker 3: 1:32

I don't know, because it just came. One of those Ellie came back off maternity leave In Feb and then it was just like I don't you miss us, because we missed you. We did and we sat down and went. Oh, this is lovely. Yeah, it's nice to be back in the seat. We're back, so we don't have any questions, because we didn't tell anybody we're doing it. Yeah, we have to do it. So here. So I said, well, I will tell everybody about my weird experience this week instead. Shocker. No, it's weird, don't go anywhere, because it was a weird one even for me, and it's not many things are weird for me anymore, and this was weird. Yeah, so we're going to do. We're going to talk about coils, progesterone medicine that interferes and all that kind of jazz today. So it's going to be a educational one it's yeah, it's too much information.

Speaker 3: 2:20

It's a bit of a tmi slash, informational slash, educational slash. Ooh only listen when you're at home yes, and do not listen with little people around. It's not, it's, that's a good yeah, yeah, trigger warning, don't. Or just yeah, something warning. Don't listen with little children around because it's way too much information. I told my three girls and all went. All three of them went ooh so, and they're 18, 20 and 25. So don't listen to little children. So are you sitting comfortably? Good, then I'll begin Ring the bell.

Speaker 3: 2:50

It's the children. It's like when you say to little children so it was like when we had children's story time when we were little I think it was Jacqueline Ory or something. You won't even know what that is my age will know what that is and it was like when you got to sit down for story time they would say are you children? Are you sitting comfortably? Good, then I'll begin, but it just sounds like the 70s. Yes, it was. Obviously it was the 70s. You lot would be like. So, yes, so what happened to me this week? Right for the last couple of weeks, I had a bit of just such an awkward feeling down there and I was like she's already.

Speaker 3: 3:26

I'm really cringing and she I was do you know? When you think, oh, is it? You know, when sometimes you get like a little pimple or something and you begin like, or a little bit more than you begin, I think what is that? That feels a bit weird. And then you think, oh, I don't want to know what it is, because if it's anything gruesome I'll have to go to the doctor. And you think, oh, and it was getting more and more a little bit uncomfortable. And then Sunday night I thought, right, I'm going to have to investigate, because you do, don't you? You have to put your kind of big head on and think I'm going to have to see what it is.

Speaker 2: 3:57

You do have to be brave.

Speaker 3: 3:58

You do have to be brave and go. Okay, it's my own body, I need to know what that is. So I investigated and I thought, oh, that feels a bit sharp, wonder what that is. And I pulled said item and it was my IUD. Yes, it was my Mirena coil that had got dislodged and was working its way down. So I had to then obviously pull it out because it wasn't where it was supposed to be.

Speaker 3: 4:23

And yes, ladies that smarted, my eyes did water at that point because it's the most painful thing. No, it's not the most painful thing. The most painful thing was when, through lockdown, I should have had it taken out and I couldn't get an appointment and it actually got embedded in my uterus. That was the most painful one. And she did say to me at the time I think you need to come back under general anesthesia. And I said how long is the appointment likely to? And she goes. Well, there was a few months delay and I went just take it out. She went, are you sure? And I said yeah, sure, and the nurses looked away at that point because they couldn't bear to look it's worse taking it out than putting it in pain-wise?

Speaker 3: 4:58

yeah, but when the one that I had taken out during lockdown, when it was actually embedded into my uterus it was just after lockdown because they can the nurses actually looked away. And you know when the nurses look away, they're made of steel they're made of. They're made of goodness, like made in scotland from goodness. You know, at that point they literally couldn't. They were like I can't look, and that's when you know, oh shit.

Speaker 2: 5:19

So if you're not cringing it. There's something wrong with you?

Speaker 3: 5:22

yes, you know at know at that point made the bad choice, anyway. So I was like, ow, that hurt. That was my first choice B, ew, and then C, ugh, what do I do now? Now here's where it gets interesting, because I know from my knowledge that after the age of 50 and me being 51, technically I shouldn't have another coil fitted. Yeah, because they only fit them. That is the first thing you said. That's the first thing I said to you, because up to the age of 50 you can have marina coil. So I have the marina coil because it forms part of my progesterone.

Speaker 3: 5:57

The story is that obviously for HRT you need oestrogen and progesterone. We need the balance of the two, okay, and so I have the marina coil as my progesterone. So I said, oh, okay, I need to go to the doctor then tomorrow, and I called them up in the morning and I said I need to go and get my progesterone because they need to be in balance. Yeah, and I have the estrogen patch as my estrogen, clearly. So I thought I'll probably just ask them if I can go on the county patch, the the dual one, and if you're on the quantity patch. You have the estrogen patch for half of the month and then you have the dual patch for the other half of the month. And I rocked up and I I spoke to the nurse. She was lovely senior nurse, we had a good chat and, by the way, next week's episode is going to be all about new testosterone regulations that come in, which I'm very excited to talk to you about.

Speaker 3: 6:43

So you have to tune in next week as well, because it's exciting, exciting, exciting news I need to talk to you about that one I'm excited you haven't told me about it oh, I know.

Speaker 3: 6:51

Oh, it's super exciting, brilliant news. We'll leave the reaction to as and when. Yes, you need to. You need to tune in next week for episode two. So, chatting away to it and I said, can I go into the uhi patch? And she said no and I was like, oh, okay, mean, why? So it turns out because I have neuralgia. One of the medicines I have for neuralgia, which is topiamate, interacts with the progesterone and so they can't accurately gauge because it speeds up liver enzymes, so they can't accurately gauge what dose of progesterone I would then need. So they can't do a patch at all, because the patch is balanced between estrogen and progesterone, so they couldn't give me a larger patch. There's no patches that arenone, so they couldn't give me a larger patch. There's no patches that aren't balanced. They couldn't give me lower estrogen and then higher progesterone in the patch.

Speaker 3: 7:42

That doesn't work, yeah, so they'd have to give me oral progesterone and they'd have to guess, or they'd have to double the dose and that's not as safe yeah, so they could do it in the interim while I'm waiting for another coil to be fitted, but they couldn't do it long term because they don't want to give people a really, really high dose of oral progesterone. So in the instance that that's the case, what they do for women like me is I'd have to have the marina coil forever, forever. Yep, as long as I'm on hrt.

Speaker 3: 8:13

Now, if you followed me for a while or you listened to my podcast before it used to be, or the old guidelines, or the non-informed guidelines, and I hate to say that because I do love our NHS and I do love our doctors, but if you know anything about me, I've got a petition which I will put into the show notes, because doctors do not need to have HRT training, they do not have to have perimenopause training, they do not have to have menopause training.

Speaker 3: 8:37

So I have a petition, just by simply opting out. Well, they just don't have to have it, so they don't have, they just can choose not to do it. And if they do have to, it's a few hours, it's not like days and days and days or weeks or months whatever of training for the nhs. So I have a petition at the moment in the government to say, please can we make perenopause training mandatory and every gp surgery should have one fully qualified paramenopause menopause trained member of staff. Because at the moment it's russian roulette like you can go to your local gp surgery and there could be three, four fully qualified members of staff or there could be none yeah so I've got a position in the government which I will put into the show notes and please sign it if you can.

Speaker 3: 9:18

All you have to be is a uk citizen. Unfortunately it's not available to our listeners abroad. But if you can sign it, that would be amazing because we're trying to get enough signatures so that they discuss it in parliament.

Speaker 3: 9:28

Basically, unless you can share it with all your friends and we're all on the same team we are all on the same team with this because we want to get better menopause and paramonopause help for anyone in the uk. Um, as you deserve, yeah, and, and if we can get it through in this country, then maybe we can get it influence other countries as well. So that's what we're trying to do. Where do I get up to the story? So? So, if you're a woman like me that can't have the oral progesterone for any reason, then you can have a coil.

Speaker 3: 9:55

Now it used, they used to say you should take hrt for a maximum of five years. Now, the nice guidelines and again, nice n-i-c-e. Oh, isn't that lovely. You say that isn't that lovely. Um, the nice guidelines say that you, as long as the benefits outweigh the cons of having hrt, yeah, you are the one that decides how long you take the hrt, for you can have it as long as you want, until the day you die. So technically, you can have it forever. You can like forever, right, right, right. So, and I'm not saying that every woman has to have HRT. It's a very, very, very individual choice and it's your decision, whether you want.

Speaker 2: 10:30

You've always been a big advocate on that.

Speaker 3: 10:31

Yeah, you do you but you can decide I want it for five years, 10 years, 15, 20 till the 20, till the day I die. So for me I've now got to have a marina close to me for 45 years, every what 45 years? 45?, not 45. I was like well, okay. Yeah, this is a Titanic one, so I've got to go through this now every 45 years, for the next could be 50 years.

Speaker 2: 10:54

It's so worth it.

Speaker 3: 10:55

Well, I can't, I haven't got a choice. Yeah, so that's that.

Speaker 2: 10:59

And they're used to the Mirena Quilva. For how many years?

Speaker 3: 11:01

Oh, I mean, I've had it since Jenna was born.

Speaker 2: 11:04

Jenna's now 18.

Speaker 3: 11:05

So I've had already more Right. So I prepared a list of medicines, because it's not just a pyramid. Okay, and this is what you need to understand there are different medicines that will say it's not suitable for you to have a patch. Now why am I telling you this? Again, I am not bashing our wonderful NHS, I'm not bashing the wonderful doctors, but unless your doctors know that you are taking certain medications, because some of what I'm going to say is a teeny tiny little bit controversial, because some of the things that you may say is a teeny tiny little bit controversial, because some of the things that you may be doing you might not be telling your doctor about. What does that mean? So I'm not being mean, you know me, I'm not mean, I'm a delight, I'm a joy, I'm a fluffy, bunny marshmallow cookie A bit far, but yeah Well.

Speaker 3: 11:56

Some of the new weight loss injections? Ah yeah, bit far, but yeah well. Um, some of the new weight loss injections, uh yeah, are really not a good combination with progesterone, unless you're like me and you have a marina coil. Why the marina coil is because it puts the progesterone into your uterus. It doesn't. You don't take it, or at least it's not going into your system. It's going into your uterus, okay, and the weight loss injections work, have a similar problem.

Speaker 3: 12:23

But what they? What the weight loss injections do is they slow down the digestion. I mean, they're used for diet, they're used for diabetes and the use for weight loss, the semi-glutide. So we're talking about ozempic, we're talking about, we're going to be, we're talking about yeah, what's that other one, the one beginning with M? You know what I'm talking about. What they do is they slow down the stomach emptying, which is why you don't feel hungry as quickly. They change how well oral progesterone is absorbed. So if you've got the Mirena coil, it bypasses the gut.

Speaker 3: 12:54

So if you are on one of these weight loss Monjaro, that's it. You need to go and you need to be really, really honest with either your senior nurse practitioner or your GP. Tell them, because the thing is, a lot of these injections now are available on the privately, so you might not have been prescribed it by your doctor, and this is why I'm saying you need to be going to your doctor having a really honest conversation with them. Let them know that what you're doing because it might be other as well, other medicines, not just your hrt. But that's not. That's nothing to me. I'm not a circus, not my monkeys on that, but it becomes like it's not even judgment, it's a health.

Speaker 2: 13:29

It's not.

Speaker 3: 13:29

It's a health concern because any, any medicines that rely on your gut and rely on a slow release or rely on a certain time release of that medicine. What you've got to understand is now that those injections are helping your gut to slow down the release, they can affect the absorption of any medicine. So, when it comes to progesterone, it's not nothing to do with your, with your estrogen, it's just the progesterone side of things. So, whether you have it transdermally or whether you have it in oral, we just need to be careful, and the only one that we know for sure will not be affected is the marina coil, because it goes straight into your uterus and doesn't cause any problems, and it's so important to get the progesterone right because that's the one that protects you from developing a thicker uterine lining. I don't want to say the c word, but that's why um the c word.

Speaker 3: 14:24

I was like that's not appropriate.

Speaker 3: 14:25

No, that's not that, not the, not the. See you next tuesday. What version? Um, that's funny. I never clocked that. That's a good one. I like that. I introduced this to lots of people. But that's why, because when, when the lining gets thicker and thicker and thicker and out of control, that's when the danger is so. But that's why we need the eastern progesterone to be balanced, because the progesterone is the one that sheds the lining. So that's why it's so important to have them both in balance. You see, okay, that's why, if you've got a womb, yeah, we need to always make sure therogen and the progesterone are on the same page.

Speaker 2: 15:02

Okay, and it feels so much better as well, because I have a quail because I have endometriosis and I produce too much oestrogen. My life did a 180 after having the Mirena quail. My moods are regulated, my periods, my hormones.

Speaker 3: 15:15

Exactly so. Progesterone is the one that we call a soporific, so it's the one that makes you feel calmer, it makes you feel more relaxed, it makes you feel more balanced. Okay, so that's the soporific effect of it. So, if you're eastern, if so, if you've got something like endometriosis and you're eastern dominant, you're going to feel moody, you're going to feel crampy, you're going to feel headachy, you're going to feel bloated, and then, when you introduce a more balanced progesterone, it's going to make you feel calmer, it's going to make you feel more grounded, more earthed. It really does, yeah, and so that's why progesterone is really important and we have to get it right now. The problem, when you go into something like monjaro, whatever, whatever is that if you're suddenly not getting the progesterone correctly, you can end up with all these, these issues again. I don't want to harp on about it, because I don't want anyone to think that I'm having to get them, because I'm really not no, it's just to be honest.

Speaker 3: 16:10

Yeah, just be honest with your gp or your senior nurse practitioner and just say to them this is the situation, I'm on this for weight loss and it's, you know, because they can really really help. Okay, so other things that may interfere with progesterone anti-epileptics so for me it was because I have a neuralgia problem carmazapine, fentolin, fentolin sorry, um, phenovalpipital primate if I'm pronouncing these incorrectly, forgive, forgive me primidome. Then there's ones like anti-infectives. So there's some TB antibiotics, so things like rifamacine, rifabutin. There's some antifungal ones like grisifolvin, some HIV medications I'll just say what they are and then I can put them in the show notes because I'm really butchering this.

Speaker 3: 16:57

And then, obviously, the weight loss injections, so the semaglutides, like the ozempic wagovi, and even some of the ones like the dula glutides, like Trilox C, and those ones you can even get vaginal forms of progesterone. They're less common, but you could all even get those ones as well. And then there's other ones, like St John's wort, which is a herbal antidepressant that interferes with it as well. High dose steroids, bio acids, secretions yeah, this is why I pronounce it.

Speaker 3: 17:30

I'm struggling with them, it's because my brain's struggling with the word recognition. It's a lovely side effect of premenopause, but those are the things that may interfere. I would just be really, really careful. Other things like blood blood pressure tablets, non-enzyme inducing antibodies, like amoxicillin, all those ones hrt's and they're all absolutely fine. Don't worry if I haven't mentioned those. They're absolutely fine. And if you're worried, please go and see your gp.

Speaker 3: 17:59

I'm not a medical practitioner, I'm not your doctor, I'm not your nurse. I'm just telling you that there is the potential for these things to interfere. Please go and speak to. If you're worried and you're, you're taking these medicines and you're on hrt, please go and speak to your medical practitioner. They're on the side of caution because we want to make sure that you're doing the right thing for yourself. Okay, and I think that's just the most important thing is just take care of yourself and make sure that you're aware of of these things, because I didn't. I personally didn't realize, because I knew about the weight loss injections. I knew about some of the antibiotics. I didn't know that the one that I'm taking from my neuralgia because it's it's a way obscure one, it's anti-epileptic, but I take it from my neuralgia. I had no clue I'm not gonna lie, that that was one that would interfere. Okay, it's good to know.

Speaker 3: 18:54

It's good to know I've actually learned a lot today yeah, also, if your coilover falls out, it's very, very rare. I've never heard of it before. I went to see the nurse and she went. Yeah, it's unusual, but it can happen. If it does, don't panic, just go and see your nurse and she'll be like, she'll be chill. But yeah, that was a weird one, I'm not gonna lie every time you mention it.

Speaker 1: 19:17

Now I feel my own.

Speaker 3: 19:19

Yeah, that's just yeah. But I just took some ibuprofen. It didn't bleed or anything. It must have. Must be dislodged for quite a while. But yeah, weird ew. But on that note, hi, everybody, welcome back. So, as I said, next week I'm going to be telling you some very, very, very exciting news about female testosterone, why it's important, what you're going to do about it, and some great news for all the women in the uk, and I tested my own theories about how you can gain access to it, which is very, very exciting, so I will be telling you the inside gossip on that one as well.

Speaker 3: 19:57

I cannot wait yeah, so stay tuned next week. If you have any questions, as always, we will put the links in the show notes underneath. Please, please, please, ask us your questions, because that's why we're here. If you want to join our free perimenopause group, it's perimenopause with Kate Grosvenor. If you want to join our membership, it's absolutely fantastic. You can join our. Oh, we've got so much going on now and then recipes, weight loss challenges, yoga things, resources, community discount on the lifestyle brands. The whole shebang is an amazing place to be. That will be in. It is nine pounds a month, which is like pent today. Yeah, so it's a great, great, great place to be.

Speaker 2: 20:33

If you have any questions just reach out and let us know and we will see you next time it's goodbye from me, bye, take care.

Speaker 3: 20:44

Thanks for joining us today on the uncomplicated perimenopause podcast.

Speaker 2: 20:49

We hope you found this episode helpful and inspiring, don't forget if you have any questions or topics you'd like us to cover, you can reach out through our perimenopause group or on whatsapp for more information on my coaching, perimenopause supplements, books or upcoming events, please visit wwwkategrovernercom and if you've enjoyed today's episode, please subscribe, rate and review our podcast. It really helps us reach more listeners, just like you, until next time.

Speaker 3: 21:18

Remember, perimenopause doesn't have to be complicated. We're here to help you every step of the way.

Speaker 2: 21:24

Stay uncomplicated, thank you.